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[Ping An]: This section, from the beginning of the chapter to "wu lao yong li ye" (no need for strenuous effort), is found in *Ling Shu* (Spiritual Pivot), Volume 8, Chapter 48, "Jin Fu" (Prohibitions and Services), and also in *Jia Yi Jing* (Classified Classic of Acupuncture and Moxibustion), Volume 4, "Jing Mai" (Meridians), Part 1, Upper Compilation. From "Lei Gong said: The disease worsens..." to "...injury from food and drink," it is found in *Ling Shu*, Volume 8, Chapter 49, "Wu Se" (Five Colors), and *Jia Yi Jing* is the same. From "One day and one night, fifty circuits..." to "...suddenly rapid and suddenly slow," it is found in *Ling Shu*, Volume 2, Chapter 5, "Gen Jie" (Roots and Knots), and *Jia Yi Jing* is the same. From "Huang Di asked: Why does the Qi Kou (Radial Pulse) alone serve as the master of the Five Zang Organs?" to "...treatment yields no merit," it is found in *Su Wen* (Basic Questions), Volume 3, Chapter 11, "Wu Zang Bie Lun" (Discussion on the Distinction of the Five Zang Organs), and also in *Jia Yi Jing*, Volume 2, "Shi Er Jing Luo Mai Zhi Bie" (Branches of the Twelve Meridians and Collaterals), Part 1, Lower Compilation. From "Fan ci zhi dao" (The general principle of acupuncture...) to "...take from its meridian," it is found in *Ling Shu*, Volume 2, Chapter 9, "Zhong Shi" (Beginning and End), and also in *Jia Yi Jing*, Volume 5, Chapter 5, "Zhen Dao Zhong Shi" (The Way of Needling: Beginning and End). From "Ren Ying yi sheng" (Ren Ying pulse one excess...) to "...called Guan Ge (Gate Closure)," it is also found in *Su Wen*, Volume 3, Chapter 9, "Liu Jie Zang Xiang Lun" (Discussion on the Six Jie and Viscera Manifestations). From "Huang Di asked Qi Bo: When a person suffers from stomach tube..." to "...thus the stomach tube becomes an abscess, the Emperor said 'Well done'," it is found in *Su Wen*, Volume 13, Chapter 46, "Bing Neng Lun" (Discussion on Disease Capabilities), and also in *Jia Yi Jing*, Volume 11, Chapter 8, "Xie Qi Ju Yu Xia Wan Fa Nei Yong" (Evil Qi Gathering in the Lower Stomach Causing Internal Abscess). From "An wo" (Resting and lying down) to the end, it is found in *Ling Shu*, Volume 11, Chapter 74, "Lun Ji Zhen Chi" (Discussion on Diagnosing Diseases by Measuring the Limbs), and also in *Jia Yi Jing*, Volume 11, Chapter 6, "Wu Qi Yi Fa Xiao Ke Huang Dan" (Overflow of Five Qi, Wasting-Thirst, and Jaundice).

Lei Gong asked Huang Di: "I, your humble student, have received instruction from you and mastered the sixty chapters of the Nine Needles. I study them diligently morning and evening; the bamboo slips of nearby books have broken binding cords, and those of distant books are covered in dust. Yet I continue to recite without ceasing, but I have not yet fully understood their meaning." (Note: The Nine Needles tradition from the South comprises sixty chapters. For ancient bamboo slip books, the bindings of older ones have broken, while newer ones gather dust, indicating the depth and subtlety of the learning, which requires long-term diligence but remains difficult to fully grasp. Ping An: In *Ling Shu*, "yuan zhe" (distant ones) is written as "jiu zhe" (long-time ones). According to the commentary, the characters "jin" (near) and "yuan" (distant) should be swapped.) "The concept of 'Wai Chuai' (inferring internal states from external signs) states that all things are integrated into one unity, but I do not know what this specifically refers to." (Note: Chuai, pronounced 'chu wei', means to measure or estimate. Hun, pronounced 'hu kun', means to combine. Shu means summary. The auspiciousness and malignancy of the Five Zang and Six Fu organs reside internally; their Qi integrates through the Hand Taiyin Lung Meridian into one manifestation at the Cun Kou (Radial Pulse) externally, where it can be palpated and measured to be known. However, I do not comprehend its intent.) "The Great has no outside, the Small has no inside; size has no limit, height and depth have no measure. How can they be bound together?" (Note: The Qi of the meridians aligns with the numbers of Heaven and Earth, connecting thoroughly with the Dao, encompassing the Six Directions, thus having no outside. Qi penetrates the finest hairs, thus having no inside. Since formless Qi cannot be exhausted by size or measured by height/depth, attempting to summarize it into one is indeed unknowable. Ping An: The four characters "yu dao tong dong" (connecting thoroughly with the Dao) are missing in the Yuan edition's commentary.) "Scholars' talents vary in thickness or thinness; their knowledge and thoughts may be narrow and shallow, unable to reach broad and profound depths. My self-discipline in study is inferior to yours, 'Xi Zi' (a humble term Lei Gong uses for himself). I fear these teachings will scatter in later generations and be cut off from my descendants. I dare to ask: How can they be simplified?" (Note: Bian, pronounced 'bian mian', means narrow. People's learning is not as deep as Xi Zi's; fearing the Supreme Dao will be lost to future generations and fail to benefit descendants, he asks for the essence to ensure immortality. 'Xi Zi' is Lei Gong's self-deprecating name. Ping An: Comparing with *Ling Shu*, the character 'wei' (not) is absent above.)

Huang Di replied: "Excellent question! This was prohibited by our predecessors from being passed on privately; it requires cutting arms and drinking blood to swear an oath. If you wish to receive it, why do you not purify yourself first?" (Ping An: The original text had a corrupted character for 'sha' (swallow/drink blood); corrected to 'sha' based on *Ling Shu*. 'Wei meng' in *Ling Shu* is 'zhi meng'; 'qi' is written as 'zhai' (fast/purify), same below.) Lei Gong bowed twice and rose, saying: "Please instruct me." He then fasted for three nights and requested: "Daring to ask, today is the day of pure Yang; I, your humble student, wish to accept the oath." Huang Di entered the purification room with him, cut his arm, and drank blood. Huang Di prayed: "Today is the day of pure Yang; we drink blood to transmit the prescription. Whoever dares to betray these words shall suffer disaster." Lei Gong bowed twice and said: "Your humble student accepts it." Huang Di held his left hand and gave him the book with his right, saying: "Be cautious, be cautious!" (Note: Dai Ji transmitted to Qi Bo in ancient times, and Qi Bo transmitted to Huang Di; thus Dai Ji is the predecessor. The Dao must not be taught to unworthy persons, hence the prohibition against private transmission. 'Fang' means essential principles. Transmitting via oath.) "I will explain to you. The principles of acupuncture begin with the meridians," (Note: My methods aim to cure diseases, each with its key points. Sages combine various therapies; since needles are light and small, capable of curing major ailments, I speak of them first. The twelve regular meridians, eight extraordinary vessels, and fifteen collaterals traverse the body. The movement of Ying, Wei, Yin, and Yang Qi determines life span and health, nothing escapes them, so they are the beginning. Ping An: The character 'zhui' (fall) in the note is likely a scribal error for 'sui' (tunnel/path).) "Manage the Qi flowing within them, and know their measurements," (Note: The principle of needling requires managing and following the Qi flowing through the twelve meridians and collaterals, and knowing the length and measurement of the pulses. Ping An: In the note, 'mai' (pulse) is erroneously printed as 'fei' (lung) in the Yuan edition.) "Internally, sequence the Five Zang organs, and distinguish the Six Fu organs," (Note: Meridians flow out from the Zang-Fu to the exterior, so Zang-Fu are called 'internal'. To understand the internal, first sequence the Yin of the Five Zang, then distinguish the Yang of the Six Fu. Ping An: In the note, 'zhi nei' (know internal) is erroneously printed as 'zhi dao' (know way) in the Yuan edition.) "Examine the Wei Qi (Defensive Qi), which is the mother of a hundred diseases; regulate their deficiency and excess, then drain the blood collaterals. Once the blood collaterals are cleared, there will be no danger." (Note: First understand that Wei Qi, being Yang and moving externally, receives various evil Qi to become the source of a hundred diseases. Then determine the deficiency/excess of the meridians. For excess, stop tonifying and apply draining methods, starting with major and minor blood collaterals. Once blood evil is exhausted, danger is avoided. Ping An: *Ling Shu* repeats 'xu shi' (deficiency/excess) after these terms. 'Xue luo jin er bu dai' in *Ling Shu* is 'xue jin bu dai yi'.)

Lei Gong said: "These are all things I understand, but I do not know how to simplify them." Huang Di said: "Simplifying a prescription is like tying a bag. If a bag is full and not tied, it leaks. If a prescription is formed but not simplified, the Shen (Spirit) will not accompany it." (Note: Yue means restraint/moderation. Fang means method. Prescriptions diagnose Qi, bags hold Qi, hence the comparison. A full bag untied will leak Qi; a diagnosis method unsimplified will leak Shen Qi. When Shen Qi departs, it does not circulate with the body, hence 'not accompanying'.) Lei Gong said: "For those of lower capacity, do not let it fill up before restraining it." Huang Di said: "If one knows how to restrain before the condition is full, one may be called a craftsman (Gong), but cannot serve as a teacher for the world." (Note: In the path of preserving life, talents vary. When diagnosis methods are complete and restrained reasonably, leading to long life, one is of superior virtue and talent, fit to be a teacher for the world. If diagnosis methods are not yet perfected, but one can restrain and act, one may serve as a state teacher, diagnosing disease origins via pulse. Such a person is called a 'Gong' (craftsman/doctor), representing talent that is not inferior. Ping An: *Ling Shu* adds the character 'wei' (to be) before 'tian xia' (the world).) Lei Gong said: "I wish to hear about becoming a Gong." (Note: Becoming a Gong relates to the art of pulse-taking, hence the question.)

Huang Di said: "Cun Kou (Radial Pulse) governs internal [conditions]," (Note: Referencing *Jiu Juan* and *Su Wen*, the Lung Meridian of Hand-Taiyin moves at the Cun Kou and Chi Kou of both hands. 'Kou' means passage for Qi. Cun Kou connects to Hand-Taiyin Qi, hence named Cun Kou. Where Qi flows, it is also called Qi Kou. Cun Kou and Qi Kou are identical. 'Zhong' refers to the Five Zang, which are Yin. The Qi of the Five Zang manifests at Cun Kou via the Hand-Taiyin meridian, so Cun Kou pulse governs the interior.) "Ren Ying (Carotid Pulse) governs external [conditions]," (Note: On both sides of the Adam's apple, the Foot-Yangming Stomach Meridian welcomes the Qi of the Five Zang and Six Fu to nourish the body, hence named Ren Ying. Lower classics say: Ren Ying is the Stomach Meridian. Also: The arterial pulse on the side of the Ren Mai, Foot-Yangming, is named Ren Ying. *Ming Tang Jing* says: The large artery in the neck, beating at the hand, flanking the Adam's apple, is used to observe the Qi of the Five Zang. Ren Ying is the Stomach Meridian, head of the Six Fu, beating externally; observing it reveals the interior, hence 'governs external'. Cun Kou is below, at the two hands, considered Yin; Ren Ying is above, at the throat sides, considered Yang. *Jiu Juan · Zhong Shi* says: A peaceful person is disease-free. Disease-free people have pulses at Mai Kou and Ren Ying corresponding to the Four Seasons. Corresponding to Four Seasons means upper and lower respond, coming and going together. Mai Kou refers to Hand-Taiyin Qi moving at Cun Kou, so Cun Kou Mai Kou are identical. If upper and lower come and go together, how can two hands define upper and lower? Also, *Jiu Juan · Zhong Shi* says: If Ren Ying and Taiyin Mai Kou are both excessive by four times, it is called Guan Ge. Thus, Hand-Taiyin has no Ren Ying. Also, *Su Wen* Vol 5 discusses stomach tube abscess diagnosis: Qi Bo said, the pulse should be Chen Xi (deep and fine). Chen Xi Stomach pulse indicates reversed Qi; reversed Qi makes Ren Ying very excessive; excessive means heat. Ren Ying is Stomach Meridian; reversed and excessive means heat gathers at the stomach opening and does not move, causing stomach tube abscess. This scripture mentions Ren Ying and Cun Kou locations dozens of times, yet never designates Left Hand Cun Kou as Ren Ying or Right Hand Guan Shang as Cun Kou. Traditional practice, even with slight knowledge, relies on other annotations, which people trust despite lacking basis, and thus should not be followed. Ping An: In the notes, both instances of 'wei guan' (stomach tube) have 'guan' erroneously printed as 'ying' in the Yuan edition.) "They correspond to each other, coming and going together, like pulling a rope with equal tension," (Note: Cun Kou and Ren Ying, though differing in upper/lower Yin/Yang, share one Qi. Upon exit, both pulses go; upon entry, both pulses return. It is like two people pulling one rope: if pulled away, the rope goes; if pulled back, the rope comes. Cun Kou and Ren Ying, driven by respiration, move together, hence 'equal'.) "In Spring and Summer, Ren Ying is slightly larger; in Autumn and Winter, Cun Kou is slightly larger. Such a person is called a Ping Ren (Healthy Person)." (Note: Like pulling a rope, tensions are equal, but subtle differences exist. One end pulls larger, the other smaller; vice versa. Pulses are similar: though one, they move with respiration. Due to abundant Yang Qi in Spring/Summer and Yin Qi in Autumn/Winter, there are slight size differences. Spring/Summer Yang abundance suits the pulse, making slight enlargement normal. Autumn/Winter Yin abundance suits the pulse, making slight enlargement normal. 'Ping' means harmonious Qi without disease. Ping An: The character 'wei' (slightly) is missing in the phrase 'gu wei you da xiao' in the Yuan edition's note.)

"If Ren Ying is one time larger than Cun Kou, the disease is in Shaoyang; two times larger, in Taiyang; three times larger, in Yangming." (Note: Considering Spring/Summer when Ren Ying is slightly larger than Cun Kou, Shaoyang disease already exists but is mild, hence not mentioned. Naming occurs when the disease forms, e.g., 'one time' implies Shaoyang disease. Normally, non-diseased persons have equal pulse sizes. In Spring/Summer, Ren Ying is slightly larger than Cun Kou, which is normal. As Ren Ying grows by half, then more, to one time, Shaoyang disease is indicated. Shaoyang Qi is not yet extreme, exceeding Yin by one time, named Shaoyang disease, making Ren Ying one time larger than Cun Kou. As Shaoyang disease Qi grows, exceeding Yin by two times, it is named Taiyang disease, making Ren Ying two times larger. As Taiyang disease Qi grows, exceeding Yin by three times, it is named Yangming disease, making Ren Ying three times larger. Ping An: *Ling Shu* writes 'disease in Foot-Shaoyang, one time and restless, in Hand-Shaoyang'; 'disease in Foot-Taiyang, two times and restless, in Hand-Taiyang'; 'disease in Foot-Yangming, three times and restless, in Hand-Yangming'. *Jia Yi Jing* writes 'two times' as 'zai bei' (again).) "Excess indicates Heat," (Note: Internal excess of Yang Qi causes Heat, hence Ren Ying pulse is excessive.) "Deficiency indicates Cold," (Note: Internal deficiency of Yang Qi allows Yin to invade, causing Cold, hence Ren Ying pulse is deficient.) "Tight pulse indicates Painful Bi (Obstruction)," (Note: The Qi movement is tight and urgent. Cold and warm Qi in muscles cause Painful Bi. Ping An: In the note, 'wen' (warm) is likely a scribal error for 'shi' (damp) based on the following note 'han shi qi ju' (cold and damp Qi reside).) "Intermittent pulse indicates symptoms fluctuating between severe and mild." (Note: Dai means stopping. Pulse cessation is called Dai. Dai pulse occurs when evil Qi lodges in blood collaterals, changing with diet, causing symptoms to fluctuate.) "Excess requires Draining," (Note: Ren Ying one excess drains Shaoyang; two excesses drain Taiyang; three excesses drain Yangming.) "Deficiency requires Tonifying," (Note: Ren Ying deficiency means Ren Ying is smaller than Cun Kou. One time smaller tonifies Shaoyang; two times smaller tonifies Taiyang; three times smaller tonifies Yangming.) "Tight pain requires selecting points in the muscle spaces," (Note: Cold and damp Qi reside in muscle spaces.) "Intermittent pulse requires draining blood collaterals and administering medicine," (Note: Evil in blood collaterals causes Dai pulse;刺 (puncture) to remove evil blood and drink decoctions to strengthen.) "Sunken/depressed pulse requires Moxibustion," (Note: When vessel Qi and Blood are insufficient and sunken/unseen, it indicates internal Cold, requiring moxibustion.) "Neither excess nor deficiency requires treating the affected meridian, called Jing Ci (Meridian Puncture)." (Note: Neither excess nor deficiency indicates direct disease of the proper meridian. E.g., Heart pain caused by Wind Stroke: Liver Qi attacking Heart from behind is Deficient Evil; Diet/Labor fatigue: Spleen Qi attacking Heart from front is Excess Evil; Cold Damage: Lung Qi attacking Heart from the overcoming cycle is Minor Evil; Dampness: Kidney Qi attacking Heart from the overcome cycle is Robber Evil. These four evils are external; check Heart's Xu/Shi and tonify/drains others. Summerheat disease originates from the organ itself, is Direct Evil, and should treat its own meridian, hence 'treat the meridian', called Jing Ci.)

"If Ren Ying is four times larger, both large and rapid, it is called Wai Ge (External Gate Closure), a fatal untreatable condition." (Note: At three times, each affects one Yang. At four times, Yang is exclusively excessive, rejecting Yin externally, blocking Yin Qi. 'Ge' means rejection. Exclusive Yang excess is large and rapid. Without Yin, exclusive excess leads to decline, hence fatal. Ping An: *Ling Shu* adds five characters after 'ming yue': 'Yi Yang, Yi Yang wei' (Overflowing Yang, Overflowing Yang is...).) "Must carefully examine its root and branch, observe Cold and Heat, to verify Zang-Fu diseases." (Note: Must carefully examine Ren Ying/Cun Kou internal/external roots/branches, observe Cold/Heat in pulses, then verify Zang-Fu diseases.)

"If Cun Kou is one time larger than Ren Ying, the disease is in Jueyin; two times larger, in Shaoyin; three times larger, in Taiyin." (Note: In Autumn/Winter, when Cun Kou is slightly larger than Ren Ying, Jueyin disease exists but is mild, hence not mentioned. Naming occurs when disease forms. Normally, non-diseased persons have equal pulses. In Autumn/Winter, Cun Kou is slightly larger than Ren Ying, which is normal. When Cun Kou reaches one time larger, Jueyin disease is indicated. Jueyin Qi is weak, exceeding Yang by one time, named Jueyin disease, making Cun Kou one time larger than Ren Ying. Though Yin is little, exceeding Yang by two times is named Shaoyin disease, making Cun Kou two times larger. Taiyin is largest, exceeding Yang by three times is named Taiyin disease, making Cun Kou three times larger. Ping An: *Ling Shu* writes 'disease in Foot-Jueyin, one time and restless, in Hand-Jueyin (Pericardium)'; 'disease in Foot-Shaoyin, two times and restless, in Hand-Shaoyin'; 'disease in Foot-Taiyin, three times and restless, in Hand-Taiyin'. *Jia Yi Jing* writes 'two times' as 'zai bei'. Also, *Jia Yi Jing* lacks the eight characters 'Cun Kou san bei, bing zai Taiyin'.) "Excess causes distension/fullness, Cold in the Middle, and indigestion," (Note: Cun Kou Yin Qi is three times larger than Ren Ying, disease in Taiyin. Taiyin disease has Xu/Shi. Cun Kou Yin excess causes abdominal cold distension, Cold in Middle, and indigestion. Ping An: 'Han zhong shi bu hua' in *Jia Yi Jing* is 'han ze shi bu xiao hua'.) "Deficiency causes Heat in the Middle, discharge of pus-like stool, shortness of breath, and change in urine color," (Note: Yin deficiency allows Yang to invade, causing Heat in intestines/stomach, leading to stool resembling yellow pus. Shaoyin Qi deficiency causes shortness of breath and yellow urine. Ping An: Note 'chu qiang ru huang mi' is erroneously printed as 'chu mi ru huang ju' in Yuan edition.) "Tight pulse indicates Bi syndrome," (Note: Wind-Cold-Damp Qi remaining in muscle spaces causes Bi, making Cun Kou pulse tight.) "Intermittent pulse indicates pain that starts and stops suddenly." (Note: Cun Kou pulse stops and does not return is called Dai. Evil in muscles causes Wei Qi movement to start and stop, hence pain fluctuates. Ping An: *Jia Yi Jing* writes 'Dai ze za han za re, xia re shang han' (Intermittent pulse brings alternating cold and heat, lower heat upper cold); note says: *Tai Su* writes 'Dai ze za tong za zhi'.) "Excess requires Draining, Deficiency requires Tonifying," (Note: Regarding treatment formulas below, the draining method for excess is known only via Ren Ying.) "Tight pulse requires needling first, then moxibustion," (Note: Tightness involves Bi-pain. First use the painful area as Ying-Shu point, needle, then moxa at the needle site. Ping An: Note 'ying' is erroneously printed as 'ying' (camp/nutrient) in Yuan edition. 'Ci chu' is erroneously printed as 'ci hou' (after needling).) "Intermittent pulse requires draining blood collaterals," (Note: Intermittent pulse causes sudden pain/stop, so puncture to remove evil blood collaterals. Ping An: 'Er xie zhi' in *Ling Shu* is 'er hou tiao zhi'; *Jia Yi Jing* same, note says: "*Tai Su* writes 'xie'". Note 'za tong' is erroneously printed as 'za bing' in Yuan edition.) "Sunken/depressed pulse requires moxibustion alone. Sunken/depressed means blood stasis in the vessels, with stagnant blood, cold blood, hence suitable for moxibustion." (Note: Tu means empty/alone. Vessels sunken/unseen indicate cold in vessels, blood stagnation, suitable for empty moxibustion without prior needling. Ping An: 'Tu jiu' in *Jia Yi Jing* is 'cong jiu'. Note 'xue jie' is erroneously printed as 'xue bei'; 'bu jia' erroneously printed as 'bu fu'.) "Neither excess nor deficiency requires treating the affected meridian." (Note: Follows Ren Ying logic.)

"If Cun Kou is four times larger, it is called Nei Guan (Internal Gate Closure). Nei Guan is both large and rapid, a fatal untreatable condition." (Note: Yin Qi three times larger than Yang, disease in Three Yin. At four times, Yin is exclusively excessive, closing internally, blocking Yang entry, hence Nei Guan. 'Guan' means closure. Cun Kou large and rapid indicates Yin Qi nearing extinction, hence fatal. Ping An: 'Nei Guan' is erroneously printed as 'Nei Xian' in Yuan edition, note same; corrected per original.) "Must observe the Cold/Warmth of root and branch to verify Zang-Fu diseases," (Note: Must observe Cun Kou/Ren Ying size/endings Cold/Warmth to know internal/external Zang-Fu diseases. Ping An: 'Zhi han wen' in *Jia Yi Jing* is 'cha qi han re'.) "Unblock their Ying and Shu points, then the great principles can be transmitted. The great principles say: Excess requires draining alone, Deficiency requires tonifying alone," (Note: Knowing the location of Zang-Fu diseases, first use needles/herbs to unblock Ying-Shu points, then transmit the great principles of moxa/needling, referring to empty tonification/draining counts. Ping An: *Jia Yi Jing* 'Da shu ri sheng' is 'Da yue sheng'; 'Xu' has 'Xiao yue' above; both 'tu' are 'cong'.) "Tight pulse requires moxa, needling, and medicine," (Note: For tight pulses, all three therapies apply. Tight means movement stops. Small number with return is called Jie (knotted).) "Sunken/depressed pulse requires moxibustion alone," (Note: Following previous Ren Ying. Ping An: *Jia Yi Jing* 'tu' is 'cong'.) "Neither excess nor deficiency requires treating the affected meridian. So-called Jing Zhi..."